Two for One

How House Democrats can pass health care reform without voting for the health care bill.

President Obama has repeatedly called for an up-or-down vote on health care reform. But the only way House Democrats may be able to pass health care reform is by not holding an up-or-down vote. Follow me, Alice, and I'll try to explain.

There are several interlocking dramas going on in the House. Speaker Nancy Pelosi is trying to round up votes, settle on the final strategy (which elements will be in a bill voted on now and which might be voted on later), and figure out how to order the process so that Democrats limit their political exposure.

It is this third matter that leads to the prospect of giving the president what he wants but not exactly the way he wants it. The problem is that House Democrats have to vote on two bills and they really don't like one of them. Let's call them Bill A and Bill B. Bill A, the Senate health care bill, has already passed with 60 votes. House Democrats don't like it. It has the "cornhusker kickback," insufficient subsidies for middle-class families, and other flaws. So they plan to fix Bill A with Bill B, a reconciliation bill. Bill B is the one House Democrats like.

The rub is that House Democrats don't want to vote on Bill A without assurances that Bill B will make it through the Senate and become law. If it doesn't, they get stuck having voted for the politically unpleasant Bill A without being able to say they tried to fix Bill A with Bill B.

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House and Senate Democratic leaders have been talking for weeks about how to solve this problem. The parliamentarians of both chambers—who aren't part of the negotiations but who are central to them because these parliamentarians decide which procedural matters are proper—have also been consulted. (These guys could sink the entire enterprise if they wanted to.) So Democratic leaders ask them questions about hypothetical approaches and, based on their answers, try to come up with a way forward. It gets further complicated when members of the House leadership try to make plans based on what the Senate parliamentarians will do.

One method for accommodating the situation (first reported in CongressDaily) would allow the House to vote on the Bill B and, after doing so, simply consider the Senate health care bill (Bill A) as passed. There would be no actual up-or-down vote on the underlying bill. This would be the legislative equivalent of the economist's old trick of assuming a can opener.

This approach would serve two purposes. First, Democrats who think the Senate bill doesn't sufficiently limit abortion rights would never have to be on record as having voted for it. (Because the Senate abortion language can't be fixed in Bill B for procedural reasons, some Democratic aides say there is talk about a later bill that would handle these issues.) Second, if the Senate didn't fulfill its end of the bargain by voting on Bill B—remember, it's already passed Bill A—then House Democrats would be able to say: I never voted for that crummy Bill A. In fact, I only voted for that nifty Bill B to fix it.

The House has used a similar "self-executing" approach with budget votes. Under the "Gephardt rule," a vote on the budget can also count as a vote to raise the debt limit.

Republicans will try to say that the vote on Bill B is the equivalent of a vote on Bill A while arguing that this sleight of hand represents just another contortion in the Democrats' headlong effort to pass health care. (They'll also make a similar argument about a vote on the "rule" that allows all of this to take place, but if I spend too much time explaining that, you'll never come back here again.) Democrats will hope this maneuver will allow them to pass health care and move on to championing all the new benefits people can enjoy.

As for the president: All this parliamentary maneuvering complicates his message. For the last few weeks, Obama and his allies have specifically called for an "up-or-down" vote on health care. It's an effort to blunt the Republican charge that what the White House is asking for—specifically, to use the reconciliation process in the Senate—is somehow undemocratic. By using the phrase "up-or-down vote," Democrats steer the conversation back toward the more simple idea of a majority vote.

As of late Wednesday, the president's team was still on-message. "As the President has made clear, Americans deserve a final up-or-down vote on health reform," David Plouffe, president Obama's political strategist, e-mailed supporters. "And the House is now expected to hold its final vote as soon as one week from today."

Well, maybe not quite an up-or-down vote as you or I would understand it.